Practicing AAC in Acute Care Setting

Debora Downey, M.A., CCC-SLP

This text-based course is a written transcript of the course, "Using Spirometry to Diagnose and Treat Vocal Cord Dysfunction", presented by Bridget Russell on February 28, 2011.

This text is being provided in a rough draft format. Communication Access Realtime Translation is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings.

>> Amy Natho: I would like to welcome everybody to our SpeechPathology.com Virtual Conference on Augmentative-Alternative Communication. We're glad to have Filip Loncke here to serve as our guest moderator this week. Today's seminar is "Practicing AAC in Acute Care Settings," presented by Debora Downey, and it is the third in our week-long series of seminars about AAC. Welcome, Filip. I'm going to hand it over to you to introduce our speaker for today.

>> Filip Loncke: Thank you, Amy, for your introduction. Let me say that I am very honored to be chairing this series of sessions the whole week. I'm especially excited about today's presentation. I have been involved in AAC for more than 20 years and if there is one area that actually needed to get more attention and more progress, it is the area of AAC in hospital and medical settings, especially acute care settings. So many people in the field are very excited and happy that two years ago or almost 3 years ago now, a book was published on AAC in acute care settings, and it was written by Richard Hurtig and Debora Downey. I'm pleased that Debora was willing to present today for this series, because we could not find a better person than her to give this presentation. Let me first introduce Debora. She's a Doctoral Candidate at the University of Iowa and Facilitator of the AAC Services at the Center for Disabilities and Development. She is also the co author of Implementing AAC In Acute Care Settings and other journal articles. Debora also provides AAC services to critical care units at the University of Iowa hospitals and clinics. Without much further ado, Debora, we want to hear what you have to tell us. Thank you.

>> Debora Downey: Thank you, Filip, for that introduction. I am pleased to be here. I'm excited to be adding information about practicing AAC in acute care settings. I'm just curious how many people in the audience have practiced AAC in the hospital setting, not in an outpatient setting but rather with acute care patients? I see from your responses that there are a few of you. Good. Hopefully then, after today we'll all be a bit more knowledgeable about things that happen in the acute care setting. For the most part I'm going to hold the questions until the end of this session.

Objectives

Let's just do a little bit of housekeeping here. These are some of the objectives that we're going to go over. One goal was for you to be able to identify individuals who might be a candidate for AAC in acute care settings. I wanted to increase your knowledge base of strategies that you could use with patients where AAC would be an appropriate implementation. In addition, I wanted you to have just a little bit of an idea of how you might design a message template and how you would use environmental controls. We're going to just touch base on that, and we'll go over that kind of quickly. Then hopefully, I want you to have some sense of how you might educate nurses, because I think nurses are a key component to AAC in acute care settings running functionally and with minimal assistance by the speech pathologist. The reason I say that is that the nurse is really the frontline person, and the primary communication partner for the patient. So it's really necessary that we help educate our nurses about individuals who have complex communication needs.

I do want to stress that as we go through this today, when we talk about AAC, I will mention high-end use, but it is not just high-end use that we will be talking about. There are a lot of low-level ways to communicate and some mid-level technology as well. So with that, let's go ahead and start.

The Problem

I think we sometimes forget that there are many individuals in the hospital who have complicated communication needs or complex communication needs. Right now, I think if we polled what was happening in the hospitals across the nation, we'd find that most of what we see in terms of service delivery from a speech pathologist is that they are delivering some type of swallowing intervention. It seems like in a hospital setting, swallowing is "swallowing up" all the speech and language hours that anybody might produce. I understand why that happens, because of course if you think about billing, it is a money maker.

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Debora Downey, M.A., CCC-SLP

Debora is doctoral candidate at the University of Iowa and the facilitator of the AAC Service at the Center for Disabilities & Development. She is a co-author of Implementing AAC in Acute Care Setting and has published in a variety of journals. Debora also provides AAC services to the critical units at The University of Iowa Hospitals & Clinics.